2025 National Guidelines on the Mediterranean Diet: Executive Summary of a Joint Report by Italian Scientific Societies and the National Institute of Health Task Force on Clinical Practice Guidelines

Context: Chronic non-communicable diseases (NCDs) are the leading global causes of morbidity, mortality, and escalating health care costs, driven largely by unhealthy lifestyles in an aging population. Objective: The Mediterranean Diet (MD), traditionally associated with healthy longevity, is increasingly recognized for its preventative and therapeutic benefits across many NCDs. Data sources: Using the NUTRIGRADE methodology, a multidisciplinary panel of clinical, methodological, and public health experts conducted a comprehensive systematic review across 9 health domains and one economic domain. Data extraction: Data were extracted from multiple databases without date restrictions, assessing outcomes such as disease incidence and prevalence, mortality rates of nutrition-related NCDs, quality of life indicators, and relevant biochemical markers. Evidence was critically appraised and synthesized to formulate evidence-based recommendations. Data analysis: A total of 84 evidence-based recommendations were developed. The MD was found to significantly reduce all-cause mortality in the general population and cardiovascular morbidity and mortality, particularly in high-risk individuals. High-quality evidence supports the protective role of the MD against myocardial infarction, stroke, atrial fibrillation, and peripheral arterial disease. In oncological evidence, MD adherence has been found to be linked to a lower incidence of several cancer types and improved survival outcomes. Additional benefits include reduced incidence and progression of cognitive decline, type 2 diabetes, metabolic syndrome, and obesity, and improved pregnancy outcomes. The strength of recommendations varied by outcome and target population, with many supported by robust evidence. Conclusions: The MD is a scientifically supported dietary intervention with broad preventive and therapeutic benefits. Its integration into clinical practice, public health strategies, and policy initiatives is strongly recommended to promote health and reduce the global health care burden.